Lead Poisoning

A 2-year-old girl is teething and chewing onobjects found in the home. One day prior to the presentation, the parents state that their daughter has been fussy and at times appears lethargic and pale. They also noticed their daughter clutching her abdomen in pain and refusing to eat. Laboratory testing reveals and elevated free erythrocyte protoporphyrin (FEP) level, along with basophilic stippling on peripheral blood smear.